Improving the Evidence Base for Sanitation and Hygiene: 3ie's Sanitation and Hygiene Thematic Window

2015 - 2018 • International Initiative for Impact Evaluation (3ie)


To promote a culture of evaluation and improving the current evidence base in the sanitation and hygiene sector


The Sanitation and Hygiene Thematic Window, supported by the Water Supply and Sanitation Collaborative Council (WSSCC), is aimed at promoting a culture of evaluation and improving the current evidence base in the sanitation and hygiene sector. Although there has been considerable investment in sanitation and hygiene related interventions over the past two decades, there is still a scarcity of high quality evidence in this area. Through this window, we hope to generate evidence that can inform decisions about the effective allocation of funds to sanitation and hygiene-related interventions. This window comprises two impact evaluations of sanitation and/or hygiene interventions in WSSC’s priority countries, and two systematic reviews on topics in the hygiene and sanitation sector.

Impact evaluations
An evaluation in the Amhara region of Ethiopia will examine the impact of an enhanced community-led total sanitation and hygiene programme on health-related outcomes such as enteric infection, anxiety, depression, subjective well-being and sustained behaviour change concerning hygienic practices. A hallmark of this project is the confluence of water, sanitation and hygiene promotion with neglected tropical disease-preventive behavioural promotion.

The other impact evaluation under this grant is of the Global Sanitation Fund’s sanitation programme in Bihar, India. The research team is looking at the impact of the programme on the health and well-being of women and girls. Their primary outcome measure is sanitation-related psychosocial stress, which involves empirically-grounded domains of environmental stressors, social stressors, and gender-based violence stressors related to defecation, menstrual hygiene management, and post-defecation cleaning. Secondary outcome measures are broadly grouped into three main categories: psychosocial and quality of life outcomes, self-reported health outcomes, and biomarkers. The researchers are using scales for perceived stress, psychological distress, subjective well-being, vitality, mood, biomarkers of hair cortisol and health outcomes. Both impact evaluations are set to conclude in 2018.


Image: 3ie Sanitation and Hygiene Thematic Window


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Promoting a culture of evaluation and improving the current evidence base in the sanitation and hygiene sector.

Further information

Both systematic reviews from this grant have recently been published on the 3ie website:
Promoting handwashing and sanitation behaviour change in low- and middle-income countries: A mixed methods review by De Buck and colleagues, 2017 reviews 42 studies to determine which promotional approaches might change handwashing and sanitation behaviour, including implementation factors which facilitate or hinder such approaches.

Incorporating the life cycle approach into WASH policies and programmes: A systematic review by Annamalai and colleagues, 2017 reviews 59 national and state WASH policies in several low- and middle-income countries to determine the extent to which the Life Cycle Segments (LCS) approach is incorporated into these policies. The LCS approach differs from the other segmentation paradigm, Geographic and Social Segmentation, by considering individuals in segments of their lifecycle, rather than geographical and social status.

Contact information

Neeta Goel
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International Initiative for Impact Evaluation
New Delhi

3ie funds impact evaluations and systematic reviews that generate evidence on what works in development programmes and why. 3ie is an international grant-making NGO promoting evidence-informed development policies and programmes. We are the global leader in funding and producing high-quality evidence of what works, how, why and at what cost in international development. We believe that better and policy-relevant evidence will make development more effective and improve peoplea€™s lives. Since its founding in 2008, 3ie has awarded over 200 grants (146 impact evaluations, 33 systematic reviews and 38 other studies) in over 50 countries, with a total value of US$ 84,225,205. 3ie has offices in New Delhi, London and Washington, DC. The three main funders of 3ie are the Bill & Melinda Gates Foundation, UKaid through the Department for International Development and the William and Flora Hewlett Foundation. 3ie manages two sanitation-related thematic windows; one funded by the Water Supply and Sanitation Collaborative Council, and another funded by the Bill & Melinda Gates Foundation. The former aims to generate evidence on the psychosocial effects of sanitation, and the latter, promoting latrine use in rural India.

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